Provider Demographics
NPI:1942332036
Name:WASHINGTON COUNTY BOARD OF MRDD
Entity Type:Organization
Organization Name:WASHINGTON COUNTY BOARD OF MRDD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-373-3781
Mailing Address - Street 1:1701 COLEGATE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1335
Mailing Address - Country:US
Mailing Address - Phone:740-373-3781
Mailing Address - Fax:740-373-1373
Practice Address - Street 1:1701 COLEGATE DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1335
Practice Address - Country:US
Practice Address - Phone:740-373-3781
Practice Address - Fax:740-373-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2130545Medicaid
OH2354796Medicaid
OH2465032Medicaid
OH2568136Medicaid
OH8400019Medicaid